Nail changes may appear as early as sixth week7 and consist of leukonychia
, distal onycholysis, brittleness, sublingual debris and koilonychias.9 The exact mechanism is unknown.
His fingernails also showed punctate leukonychia
; small, blackish linear streaks between hyperpigmented bands; and hyperkeratosis in the hyponychium, which obliterated the distal groove, again predominantly on the right hand (Figure 1, informed consent has been obtained from the patient).
Nail discolouration was the most notable nail change in our study, with leukonychia
being more common than hyperpigmentation.
Key Words: Idiopathic acquired leukonychia
However, those white dots, known as leukonychia
, are actually down to a previous injury to the nail bed.
This nail disorder is uncommon, and is 1 of 3 forms of leukonychia
caused by abnormalities in nail bed vascularization.
Disease Frequency (n) Percentage(%) Yellow discoloration 93 43.3 Hyperpigmentation 77 35.8 Pallor 65 30.2 Ecchymosis 23 10.7 Solar elastosis 17 7.9 Pruritus Generalised 62 28.8 Localised 42 19.5 Xerosis 127 59.1 Prurigo nodularis 4 1.9 Lichen simplex 2 0.9 chronicus Excoriation 5 2.3 Absence of lunulae 30 14.0 Splinter haemorrhage 41 19.1 Leukonychia
2 0.9 Longitudinal ridging 55 25.6 Half-and-half nail 26 12.1 Koilonychia 22 10.2 Onycholysis 1 0.5 Contact dermatitis 1 0.5 Folliculitis 11 5.1 Furunculosis 2 0.9 Delayed wound healing 3 1.4 Table 2: The relationship between skin disease and occupation.
Affected nails show proximal leukonychia
that progresses distally with nail growth.
Anemia, jaundice, cyanosis, clubbing, koilonychia, leukonychia
26.31% patients presented with nail changes, and included paronychia (7.89%), nail fold telangiectasia (5.26%), onycholysis (5.26%), ragged cuticles (2.63%), leukonychia
(2.63%), splinter haemorrhages (2.63%).
Bianca AMANY people believe that white spots on the nails, called leukonychia
, are linked to calcium deficiencies but this is not the case.
. This presents as a total or partial whitening of the nail unit due to changes in the nail plate or in the nail bed epithelium.